Aspiring OBGYNs worry about adequate training after Roe V. Wade

  • Several states have imposed abortion bans since the Supreme Court overturned Roe v. Wade.
  • The decision has many medical students interested in becoming an OBGYN concerned.
  • Students said abortion bans could limit their education and exposure to life-saving care.

Before the Supreme Court overturned Roe v. Wade, Lyle Suh was considering becoming an obstetrician-gynecologist.

But now she’s less sure.

“It pushed me more for my own mental health,” Suh, who is in her third year of medical school, told Insider. “I really can’t see myself going into a field that’s so governed. Like medicine already has so many things that are out of our hands – this kind of just adds another link to what we can do .”

Suh’s experience echoes that of other medical students who are considering majoring in reproductive care but also recognize that they will be entering a field where they will have to navigate confusing bureaucratic catacombs and a political minefield.

“All these obstacles will have to be overcome”

Natalie Sorias, a third-year medical student at the University of Massachusetts, told Insider that she is passionate about women’s reproductive health, and despite the challenges she faces, she will likely continue to strive to work in the field.

“I went into medical school trying to be as open-minded as possible,” Sorias told Insider, “but the population I really care about is women.”

Sorias, who also researches female genital mutilation in Cairo, said she noticed that “the people who were neglected were women” and that it “inevitably affects the children”.

As a first-generation Egyptian-American, Sorias said she was disappointed, devastated and angry by the decision to overturn Roe v. Wade.

“Being immigrants — people come to America bragging about its advances and its incredible health care and all that,” he said. “I was just really hoping that being in this country would mean that I’m part of the global reproductive justice paradigm. It’s a bit of a shame that we’re not and it’s really disappointing for the people it’s going to affect.”

abortion opponent protest sign

Pro-life protesters carry signs as they march on January 23, 2006 in downtown Los Altos, California. Dozens of pro-lifers from St. Nicholas Church marched to mark the 33rd anniversary of the Supreme Court’s decision to legalize abortion.

Photo by Justin Sullivan/Getty Images

Now she worries about matching with a residency program in a state that doesn’t offer the full range of reproductive health education, including abortion at various stages, and how competing programs might fare in states where abortion is legal.

After medical school, students continue training in a residency program, where they become resident physicians. Nearly 44% of obstetrics and gynecology residents — or 2,638 out of 6,007 — train in programs located in states that are “certain or likely to lack access to abortion education” because of statewide bans on the procedure, according to in April. study published in the journal Obstetrics & Gynecology.

“It’s not just difficult,” Sorias said. “It also greatly increases the competition for anyone trying to get in [Obstetrics]which is guarding a career that needs more providers to start.”

Eshani Dixit, a medical student at Rutgers Robert Wood Johnson Medical School, echoed Sorias’ concern.

“It certainly seems more and more difficult to make sure that I have access to education that is not only related to my desire to be an abortion provider, but also related to just practicing obstetrics and gynecology as a field and making sure that ‘we’re providing quality care to our patients,” Dixit told Insider.

She said she fears she is in a situation where only a medical emergency will allow her to legally have an abortion.

“But I’m nervous about being in these types of situations and not having the exposure to adequately care for the patients I serve,” she said.

Morgan Levy is a third-year medical student at the University of Miami in Florida, where abortions are prohibited after 15 weeks with few exceptions, such as to save the life of a pregnant patient.

Levy said she would have to consider an out-of-state residency rotation because she is concerned that there is “a significant amount of training in the field” that she “wouldn’t be able to get simply because the procedure wouldn’t be legal for a patient to get. ”

“I think that’s a reality that a lot of students are going to face,” Levy said. “They’re going to have to go through all these barriers to go and find somewhere they can actually get the education they’re looking for.”

“We do what’s best for the patient”

abortion provider

A general view of an exam room inside the Hope Clinic For Women in Granite City, Illinois, on June 27, 2022. – Abortion is now banned in Missouri.

ANGELA WEISS/AFP via Getty Images

The Obstetrics & Gynecology study recommended that programs establish “travel exchanges for residents to receive abortion education in states with protected abortion access.” However, the study noted that travel exchanges may not be feasible for the large number of residents who study in states with limited access to abortion.

The Accreditation Council for Graduate Medical Education, which accredits residency programs, has submitted proposals that would require programs in states with abortion restrictions to provide residents with alternative training in states that do not.

“The proposed revisions help ensure that obstetrics and gynecology education programs provide residents with the necessary knowledge, skills, and abilities to practice comprehensive reproductive health care in the United States without resulting in any resident, physician trainee, or residency program.” the ACGME spokesman said in a statement.

The proposed revisions are still open for public comment before being submitted to the ACGME Board of Directors for approval.

Suh said she fears providers will become too apathetic to patients’ needs as they now find themselves in uncertain situations when seeking abortions.

“We do what’s best for the patient. We go from the best treatment to the next,” he said. But she said if she ends up with state abortion restrictions, then the scope of her training and the care she can provide is compromised.

He added that he believes doctors should do everything they can to do no harm, and “when there are fully defined laws that prevent you from providing the best possible care to a patient, that’s just very mentally taxing.”

Suh said that even if it ends up in a state where abortion is not strictly prohibited, there is still a ripple effect.

“Even though we’re in a state where it’s still very legal to have an abortion, we’re seeing a marked increase in the number of people coming to see what options there are for becoming permanently infertile,” Sue said.

Both Sorias and Suh said they are concerned about the adequate training all residents will receive in OBGYN as a result of states’ differing policies.

“Every OBGYN should be well-trained and competent in providing abortions because they are lifesaving care,” Sorias said. “So it doesn’t make sense to me that over 50% of the country’s OBGYN providers are in a place where they don’t know how to do this. I would be very disappointed and scared.”

Maureen Phipps, CEO of the American College of Obstetricians and Gynecologists, said that after Roe is overturned, “the impact on physician education will be tremendous and the consequences will be long-lasting.”

“Medical training should be comprehensive and our interns should be prepared to meet all patient needs with confidence. When 44% of OBGYN residents train in states that now have the authority to ban abortion, patients they should question whether their gynecology has had access to the quality of education we have all come to expect,” Phipps said in a statement.

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